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社会支持对中老年癌症幸存者记忆老化的影响:一种边际结构建模方法。

Effect of social support on memory ageing of middle-aged and older cancer survivors: a marginal structural modelling approach.

作者信息

Westrick Ashly C, Yu Xuexin, O'Shea Brendan, Kobayashi Lindsay C

机构信息

Epidemiology, University of Michigan, Ann Arbor, Michigan, USA

Epidemiology, University of Michigan, Ann Arbor, Michigan, USA.

出版信息

J Epidemiol Community Health. 2025 Jun 11;79(7):484-490. doi: 10.1136/jech-2024-222962.

Abstract

BACKGROUND

While social support is associated with better cognitive health among cancer-free individuals, this relationship is understudied among cancer survivors. We investigated whether overall social support before and after a cancer diagnosis is related to post-diagnosis memory ageing, overall and by sex/gender.

METHODS

Data were from 2044 cancer survivors in the US Health and Retirement Study (HRS; n=1395) and English Longitudinal Study of Ageing (ELSA; n=649) from 2006 to 2018. Incident cancer diagnoses and memory function (immediate and delayed word recall) were assessed biennially. Social support was assessed every 4 years in the HRS and biennially in ELSA. We established three time points relative to a cancer diagnosis: pre-diagnosis (the wave prior to cancer diagnosis), time 1 post-diagnosis (the first wave after a cancer diagnosis) and time 2 post-diagnosis (the second wave after a cancer diagnosis). Multivariable-adjusted marginal structural models incorporating inverse probability of treatment and attrition weights estimated the relationship between overall social support and memory function post-diagnosis.

RESULTS

Prior to a cancer diagnosis, 45.1% of participants reported high social support. Cancer survivors reporting higher social support at time 2 had better memory function post-diagnosis than those with lower social support (0.14 SD units; 95% CI: 0.03 to 0.24) which was stronger among women (0.18 SD units; 95% CI: 0.02 to 0.34) than men (0.10 SD units; 95% CI: -0.03 to 0.24).

CONCLUSIONS

Social support may help promote memory function after a cancer diagnosis in mid-to-later life. Further studies with a larger sample size and differentiation of social support are warranted.

摘要

背景

虽然社会支持与未患癌症个体更好的认知健康相关,但这种关系在癌症幸存者中研究较少。我们调查了癌症诊断前后的总体社会支持是否与诊断后的记忆老化有关,总体情况以及按性别分类的情况。

方法

数据来自美国健康与退休研究(HRS;n = 1395)和英国老龄化纵向研究(ELSA;n = 649)中2044名癌症幸存者在2006年至2018年期间的数据。每两年评估一次新发癌症诊断和记忆功能(即时和延迟单词回忆)。在HRS中每4年评估一次社会支持,在ELSA中每两年评估一次。我们相对于癌症诊断确定了三个时间点:诊断前(癌症诊断前的那一轮)、诊断后时间1(癌症诊断后的第一轮)和诊断后时间2(癌症诊断后的第二轮)。纳入治疗逆概率和失访权重的多变量调整边际结构模型估计了总体社会支持与诊断后记忆功能之间的关系。

结果

在癌症诊断前,45.1%的参与者报告有较高的社会支持。在时间2报告有较高社会支持的癌症幸存者在诊断后的记忆功能比社会支持较低的幸存者更好(0.14标准差单位;95%置信区间:0.03至0.24),女性(0.18标准差单位;95%置信区间:0.02至0.34)比男性(0.10标准差单位;95%置信区间:-0.03至0.24)更强。

结论

社会支持可能有助于促进中老年癌症诊断后的记忆功能。有必要进行更大样本量以及区分社会支持的进一步研究。

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